葡萄糖-6-磷酸异构酶抗原对类风湿关节炎诊断的意义

目的 研究葡萄糖-6-磷酸异构酶(G6PI)抗原在类风湿关节炎(RA)中的诊断意义.方法 用酶联免疫吸附试验(ELISA)双抗体夹心法检测106例RA患者,53例其他风湿性疾病和35名健康志愿者血清中的G6PI抗原的分布.还同时检测了类风湿因子(IgM-RF)、抗环瓜氨酸肽(CCP)抗体、抗角蛋白抗体(AKA)、C反应蛋白(CRP)、红细胞沉降率(ESR).并对98例RA患者行手足x线片,将其按修正的Sharp评分,分为有骨侵蚀组与无骨侵蚀组.结果 ①RA患者血清中G6PI浓度显著高于其他风湿病组和健康对照组(P<0.05).检测G6PI对RA的诊断价值,采用受试者工作曲线(ROC),诊断RA的最佳临界值为0.225μg/ml,此时的灵敏性为0.868,特异性为0.853.②G6PI与IgM-RF之间具有相关性(rs=0.504,P<0.05),G6PI与抗CCP抗体之间未显示出相关性(rs=0.078,P=0.503).③通过Spearman相关性分析.未发现G6PI抗原与病情活动性指标如ESR、CRP等有相关性.④经单因素分析G6PI抗原与骨侵蚀无关(P<0.05),IgM-RF与骨侵蚀具有相关性(P<0.05).结论 G6PI抗原在部分RA患者血清中显著升高,抗G6PI抗原对RA具有良好的敏感性(86.8%)和特异性(85.3%),能作为RA患者的一种新的标志物.G6PI抗原与IgM-RF有相关性,但不完全重叠.此研究未发现G6PI与病情活动性指标及关节侵蚀之间有关联.

The diagnostic value of gluocose-6-phosphate isomerase in patient with rheumatoid arthritis

Objective To investigate the diagnostic value of gluocose-6-phosphate isomerase (G6PI) detected by an enzy-me linked immunosorbent assay (ELISA) in patients with rheumatoid arthritis (RA). Methods The G6PI was detected by ELISA in serum samples from 106 patients with RA, 53 non-RA controls with various rheumatic diseases, and healthy individuals. The level of rheumatoid factor (RF), anti-CCP antibodies and AKA were also assessed in RA patients. The correlation analysis beween G6PI and anti-CCP, IgM-RF. G6PI, anti-CCP, IgM-RF and AKA were carried out between patients with erosion and with non-erosion diseases . Results ① G6PI serum level of patients with RA was (1.61 ±1.20) μg/ml, and was (0.11 ±0.17) in patients with other rheumatic diseases, and (0.06±0.07) μg/ml in healthy individuals. There was statistical significant difference between RA patients and patients with other rheumatic diseases (P<0.05). Receiver operator curve analysis (ROC) showed an opitium cut off level for C6PI at 0.225 μl/ml. The sensitivity of G6PI was 0.868, the specificity was 0.853 in RA. C6PI was associated with RF, but was not associated with anti -CCP. C6PI ws not associated with disease activity index by Spearman' s correlation analysis. The association between above parameters with bone erosion was not detected, however. Conclusion C6PI is abnormally increased in some RA so it may be a new diagnostic marker for RA. G6PI has a reasonable sensitivity (86.8%) and with high specificity(85.3%) to RA and it is valuable for RA diagnosis. C6PI is associated with RF, but not completely overlaps. C6PI is not associated with diseases activity. No association is found between G6PI and bone erosions.